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Heavy & Prolonged Bleeding Before Menopause

Bleeding anytime after your menstrual cycles has ended can be alarming and worrisome. Most causes of bleeding before the onset of menopause are benign and treatable. In some rare cases, it may be a sign of a serious medical condition. It is best to have all instances of bleeding outside of the menstrual cycle investigated by your health care provider to be sure.

  1. What is Peri-menopause?

    • Peri-menopause, also called menopause transition, occurs two to eight years before menopause begins. During this first stage of menopause, the levels of the female hormone estrogen, which is responsible for menstruation, begins to decline. You will still have menstrual cycles, but they may be irregular, causing them to become sporadic, lighter or heavier. This irregularity in menses may also cause continuous heavy bleeding.

    Uterine Bleeding

    • One symptom of the estrogen decline in peri-menopause is the thinning of the uterine lining. The uterine, or endometrial, lining is fed by a surge in the hormone estrogen, which causes it to thicken every month. Once the level reduces slightly, the lining is shed in your monthly menstrual cycle. As the levels decrease further, the lining will not thicken, causing uterine atrophy. The lining becomes so thin with this condition that the blood vessels housed in it weaken and spontaneously burst. This causes blood to escape and may resemble a menstrual-type flow.

    Vaginal Bleeding

    • The most common cause of vaginal bleeding in the stage before menopause is vaginal atrophy. Declining levels of estrogen cause the vaginal walls to thin and become dry. This works very much in the same way as uterine atrophy, causing the blood vessels that are housed behind the walls to become weak due to the lack of solid protection. Bleeding due to vaginal atrophy is usually light and spotty, but in some cases it can be heavy. Some women only notice bleeding from vaginal atrophy after sexual intercourse.

    Other Causes

    • Another cause of bleeding before menopause is uterine polyps. Uterine polyps are bulb-shaped growths that grow from and attach to the uterine walls (endometrium). They stem from an overgrowth of cells in the endometrium caused by irregularities in estrogen and progesterone. They can grow as large as a golf ball or be even bigger and can range in number.

    Special Warning

    • All bleeding before or during menopause and outside of menstruation is considered abnormal until a diagnosis is given. Testing is required by your physician to determine whether any of the mentioned causes are what's signaling this bleeding. In some rare cases, this may be a sign of cervical or uterine cancer.

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